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Abstract
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abuse or neglect in childhood and depression in adulthood. OBJECTIVE: To
determine whether abused and neglected children were at elevated risk of major
depressive disorder (MDD) and psychiatric comorbidity, compared with matched
control subjects, when followed up into young adulthood. DESIGN: Prospective
cohort design study. SETTING: Midwestern metropolitan county area. PARTICIPANTS:
Children with substantiated cases of physical and sexual abuse and neglect
(before the age of 11 years) from January 1, 1967, to December 31, 1971 (n =
676) were matched based on age, race, sex, and approximate family social class
with a group of nonabused and nonneglected children (n = 520) and followed up
into young adulthood (mean age, 28.7 years). Main Outcomes Measures Between
October 20, 1989, and December 22, 1995, 2-hour in-person interviews were
conducted, using the National Institute of Mental Health Diagnostic Interview
Schedule, Version III Revised, to determine DSM-III-R MDD and other psychiatric
diagnoses. RESULTS: Child abuse and neglect were associated with an increased
risk for current MDD (odds ratio [OR], 1.51; 95% confidence interval [CI],
1.06-2.14; P</=.05) in young adulthood. Children who were physically abused
(OR, 1.59; 95% CI, 1.00-2.52; P</=.05) or experienced multiple types of abuse
(OR, 1.75; 95% CI, 1.01-3.02; P</=.05) were at increased risk of lifetime
MDD, whereas neglect increased risk for current MDD (OR, 1.59; 95% CI,
1.10-2.29; P<.01). Childhood sexual abuse was not associated with elevated
risk of MDD. Kaplan-Meier age-of-onset curves (log-rank statistic, 4.03; df = 1;
P=.04) showed earlier onset of MDD for abused and neglected children compared
with controls. Among those with MDD, comorbidity was higher for abused and
neglected individuals than for controls. CONCLUSION: These results support the
need for clinicians to increase efforts to detect and treat depression in
physically abused and neglected children.
neglect whereas MDD, lifetime of at were =".05)" P< 1.01-3.02; 1.75; abuse types
multiple experienced or 1.00-2.52; abused physically who Children adulthood.
young in>Language: en
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